Individual provider Active NPI

Cristina Michelle Mena Zambrana, OD

  • Optometrist
  • Rio Grande, PR
National Provider Identifier
1003587627
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
754 Issued in PR
Practice address
Rio Grande Town Center Carr 3 Suite a-19
Rio Grande, PR 00745
Phone
(787) 988-7061
NPI assigned
Sep 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 754 PR Primary

Addresses

Primary practice location

Rio Grande Town Center Carr 3 Suite a-19
Rio Grande, PR 00745

Mailing address

772 Calle Gema
San Juan, PR 00926-5806

Other practice location 1

Palma Real Carr 3 suite 170
Humaco, PR 00791
Phone (787) 850-5222

Other practice location 2

Plaza Fajardo Carr 3 Suite 125
Fajardo, PR 00738
Phone (787) 801-5896

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220303000084 PR Practitioner - Optometry 3779977087 Reassigns benefits to 1 organization
Practice locations: Fajardo, PR

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
754PRMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ecb Humacao Optometrist CurrentSince Apr 25, 2024 Accepting new patients
Ecb Humacao LLC Optometrist PastSince Feb 9, 2025 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1632355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1003587627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "772 CALLE GEMA",
            "city": "SAN JUAN",
            "state": "PR",
            "postal_code": "009265806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RIO GRANDE TOWN CENTER CARR 3 SUITE A-19",
            "city": "RIO GRANDE",
            "state": "PR",
            "postal_code": "00745",
            "telephone_number": "787-988-7061"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Palma Real Carr 3 suite 170",
            "address_purpose": "LOCATION",
            "city": "Humaco",
            "state": "PR",
            "postal_code": "00791",
            "country_code": "US",
            "telephone_number": "787-850-5222",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Plaza Fajardo Carr 3 Suite 125",
            "address_purpose": "LOCATION",
            "city": "Fajardo",
            "state": "PR",
            "postal_code": "00738",
            "country_code": "US",
            "telephone_number": "787-801-5896",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENA ZAMBRANA",
        "first_name": "CRISTINA",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-23",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "PR",
            "license": "754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rio Grande, PR

Sources for this page

Verify at the official NPI Registry.